MELANOMA

Malignant melanoma is one of the three main types of skin cancer, most of which are caused by sun damage to the skin, in particular episodes of sunburn. The other two main types are:

• basal cell carcinoma (BCC)

• squamous cell carcinoma (SCC)

Other types of skin cancer are rare (<1% of UK skin cancers).

See also Skin cancer, sun exposure

Melanoma develops from melanocytes, cells scattered among the basal cells. Typically starts as a small dark patch; can develop from normal skin or an existing mole. May itch, bleed, crust or ulcerate as it grows. Advice to patients from Cancer Research UK is to see a doctor if they have a mole that is:

• Getting bigger
• Changing shape, particularly getting an irregular edge
• Changing colour - getting darker, becoming patchy or multi-shaded
• Itching or painful
• Bleeding or becoming crusty
• Looks inflamed

Mole or melanoma? ABCD sums up differences:

• Asymmetry: a melanoma is often uneven and asymmetrical, a mole is usually round and even.
• Border: a melanoma’s border is often ragged, notched or blurred; a mole has a smooth, well defined edge.
• Colour: pigmentation of a melanoma is often not uniform, with two to three shades of brown or black, a mole is usually uniform in colour.
• Diameter: a melanoma is usually larger than a normal mole, and it continues to grow.

Measure the lesion and record a description, eg irregular margins, irregular pigmentation, nodular areas. Note and examine all other pigmented naevi, feel for regional lymphadenopathy, examine for hepatomegaly. Suspicion of melanoma warrants urgent referral to a specialist